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Systematic review of global functioning and quality of life in people with psychotic disorders

Published online by Cambridge University Press:  01 October 2018

A. G. Nevarez-Flores
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia
K. Sanderson
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia School of Health Sciences, University of East Anglia. Norwich Research Park Norwich, NR4 7TJ, UK
M. Breslin
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia
V. J. Carr
Affiliation:
Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, St Vincent's Hospital, Sydney, New South Wales, Australia Department of Psychiatry, School of Clinical Sciences, Monash Medical Centre, Monash University, Clayton Melbourne, Victoria, Australia
V. A. Morgan
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Medical School, The University of Western Australia, Crawley, Western Australia, Australia
A. L. Neil
Affiliation:
Menzies Institute for Medical Research, The University of Tasmania, 17 Liverpool St, Hobart Tasmania 7000, Australia
Corresponding
E-mail address:

Abstract

Aims

People with psychotic disorders face impairments in their global functioning and their quality of life (QoL). The relationship between the two outcomes has not been systematically investigated. Through a systematic review, we aim to explore the presence and extent of associations between global functioning and QoL and establish whether associations depend on the instruments employed.

Methods

In May 2016, ten electronic databases were searched using a two-phase process to identify articles in which associations between global functioning and QoL were assessed. Basic descriptive data and correlation coefficients between global functioning and QoL instruments were extracted, with the strength of the correlation assessed according to the specifications of Cohen 1988. Results were reported with reference to the Meta-analysis of Observational Studies in Epidemiology guidelines and PRISMA standards. A narrative synthesis was performed due to heterogeneity in methodological approaches.

Results

Of an initial 15 183 non-duplicate articles identified, 756 were deemed potentially relevant, with 40 studies encompassing 42 articles included. Fourteen instruments for measuring global functioning and 22 instruments for measuring QoL were used. Twenty-nine articles reported linear associations while 19 assessed QoL predictors. Correlations between overall scores varied in strength, primarily dependent on the QoL instrument employed, and whether QoL was objectively or subjectively assessed. Correlations observed for objective QoL measures were consistently larger than those observed for subjective measures, as were correlations for an interviewer than self-assessed QoL. When correlations were assessed by domains of QoL, the highest correlations were found for social domains of QoL, for which most correlations were moderate or higher. Global functioning consistently predicted overall QoL as did depressive and negative symptoms.

Conclusions

This review is the first to explore the extent of associations between global functioning and QoL in people with psychotic disorders. We consistently found a positive association between global functioning and QoL. The strength of the association was dependent on the QoL instrument employed. QoL domains strongly associated with global functioning were highlighted. The review illustrates the extensive array of instruments used for the assessment of QoL and to a lesser extent global functioning in people with psychotic disorders and provides a framework to understand the different findings reported in the literature. The findings can also inform the future choice of instruments by researchers and/or clinicians. The observed associations reassure that interventions for improving global functioning will have a positive impact on the QoL of people living with a psychotic disorder.

Type
Special Articles
Copyright
Copyright © Cambridge University Press 2018 

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